NR 565 Advanced Pharmacology Fundamentals Week 1-4 &
Midterm Exam Study Guide
WEEK 1 INFORMATION
Prescriptive authority
Defined by state law and nurse practice acts
Prescriptive authority determines
Which drugs can be prescribed and level of autonomy (independent vs collaborative)
Accountability of APRNs
Safe, ethical prescribing and practicing within legal scope
Consequences of prescribing outside scope
Legal and ethical violation
Valid Prescription Requirements
Must include patient name and identifiers, drug name (generic preferred), dose, route, frequency,
quantity and refills, prescriber name, credentials, and signature.
Types of Prescriptions
Written, Electronic, Verbal (limited use).
What must prescribing consider?
Diagnosis and indication, patient age, weight, comorbidities, renal and hepatic function, pregnancy and
lactation status, genetic variability, and cost and adherence.
Patient medication education
■ Purpose of medication
■ How and when to take it
■ Expected benefits
■ Common adverse effects
■ When to seek medical attention
■ Importance of adherence
Improves outcomes/reduces errors
Drug absorption
Entry of drug into bloodstream
When does the absorption process begin and end?
It begins when the drug is administered and ends when it enters systemic circulation.
, What determines how quickly a drug enters the bloodstream?
The rate of absorption determines how quickly a drug enters the bloodstream.
What does the extent of absorption describe?
The extent of absorption describes the amount of drug entering the bloodstream.
Factors influencing drug absorption
Route of administration, blood flow, GI motility and pH
How does the route of drug administration affect absorption?
The route of drug administration affects the rate and extent of absorption.
First-pass metabolism
Reduces oral bioavailability
Bioavailability
The fraction of administered drug that reaches systemic circulation unchanged.
What is the bioavailability of intravenous (IV) drugs?
Intravenous (IV) drugs are 100% bioavailable.
How does bioavailability vary with intramuscular and subcutaneous routes?
Intramuscular and subcutaneous routes of administration demonstrate varied bioavailability.
Effect of extensive first-pass metabolism
Low oral bioavailability due to a large portion of the drug being metabolized in the liver.
First-pass metabolism does NOT
Increase drug effect, occur with IV drugs, or affect distribution directly.
What is drug distribution?
Movement from blood to tissues.
What factors influence drug distribution?
Plasma protein binding, tissue perfusion, body fat and water.
What is plasma protein binding?
The binding of drugs in the bloodstream to plasma proteins, mainly albumin, affecting their distribution
and free drug levels.
Which form of the drug is active?
Only unbound drug is active.
Midterm Exam Study Guide
WEEK 1 INFORMATION
Prescriptive authority
Defined by state law and nurse practice acts
Prescriptive authority determines
Which drugs can be prescribed and level of autonomy (independent vs collaborative)
Accountability of APRNs
Safe, ethical prescribing and practicing within legal scope
Consequences of prescribing outside scope
Legal and ethical violation
Valid Prescription Requirements
Must include patient name and identifiers, drug name (generic preferred), dose, route, frequency,
quantity and refills, prescriber name, credentials, and signature.
Types of Prescriptions
Written, Electronic, Verbal (limited use).
What must prescribing consider?
Diagnosis and indication, patient age, weight, comorbidities, renal and hepatic function, pregnancy and
lactation status, genetic variability, and cost and adherence.
Patient medication education
■ Purpose of medication
■ How and when to take it
■ Expected benefits
■ Common adverse effects
■ When to seek medical attention
■ Importance of adherence
Improves outcomes/reduces errors
Drug absorption
Entry of drug into bloodstream
When does the absorption process begin and end?
It begins when the drug is administered and ends when it enters systemic circulation.
, What determines how quickly a drug enters the bloodstream?
The rate of absorption determines how quickly a drug enters the bloodstream.
What does the extent of absorption describe?
The extent of absorption describes the amount of drug entering the bloodstream.
Factors influencing drug absorption
Route of administration, blood flow, GI motility and pH
How does the route of drug administration affect absorption?
The route of drug administration affects the rate and extent of absorption.
First-pass metabolism
Reduces oral bioavailability
Bioavailability
The fraction of administered drug that reaches systemic circulation unchanged.
What is the bioavailability of intravenous (IV) drugs?
Intravenous (IV) drugs are 100% bioavailable.
How does bioavailability vary with intramuscular and subcutaneous routes?
Intramuscular and subcutaneous routes of administration demonstrate varied bioavailability.
Effect of extensive first-pass metabolism
Low oral bioavailability due to a large portion of the drug being metabolized in the liver.
First-pass metabolism does NOT
Increase drug effect, occur with IV drugs, or affect distribution directly.
What is drug distribution?
Movement from blood to tissues.
What factors influence drug distribution?
Plasma protein binding, tissue perfusion, body fat and water.
What is plasma protein binding?
The binding of drugs in the bloodstream to plasma proteins, mainly albumin, affecting their distribution
and free drug levels.
Which form of the drug is active?
Only unbound drug is active.
